[Is velopharyngeal competence stable with growth in patients with cleft palate?]

It is possible to have a good velopharyngeal closure at 8 years of age and slowly deteriorate to present with velopharyngeal incompetence (VPI) at adolescence? Authors disagree on this subject so we undertook a study to find the answer in our cleft palate population. One hundred and seventy-three patients born between 1968 and 1972 with a cleft palate or cleft lip and palate were reviewed. The appreciation of their velopharyngeal closure at 8 years of age, as rated in their chart, was classified as good (group I, 125 patients), borderline (group II, 17 patients) or incompetent (group III, 35 patients). All children in group I had a good velopharyngeal closure before the age of 8 years, some never presented any symptoms of incompetency (VPI) while other corrected this VPI before the age of 8. The group II included children presenting inconstant or mild symptoms of VPI. All patients in group III received a pharyngeal flap to correct their VPI and were not included in this follow up study. Groups I and II were recalled and 52 presented for a late clinical evaluation of their speech. Group I: 47 examined, 42 still competent, 5 incompetent: group II: 5 examined, 3 competent and 2 incompetent. It is interesting to note that in group I, all five deteriorations of the V-P competency was seen in patients who had shown some symptoms of VPI in early childhood. They had become competent spontaneously or with speech therapy, before age 8.(ABSTRACT TRUNCATED AT 250 WORDS)